You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, youll have access to competitive benefits including a fresh perspective on workplace flexibility.
****Hybrid Position: 1 day in office per week****
*****Must reside within driving distance to Pittsburg, PA or Mechanicsburg, PA*****
**Position Purpose:** Reconciles memberships and premiums between the Health Plan and government partners. Conducts timely reporting, offers process improvement recommendations, and works collaboratively on the reconciliation processes for Community Health Choices to ensure we receive the appropriate premium. Works closely with service partners within the Corporate/Regional sites and develops business contacts as deemed appropriate.
+ Provides outreach to members via phone to support with their Redetermination.
+ Provides experienced support to members to connect them to the County Assistance Offices if they need additional assistance completing the renewal packet. Ensuring they receiving high-quality customer care during the entire process.
+ Multi-tasks using multiple internal and external applications to identify and research monthly premium discrepancies between expected premium and actual payments.
+ Downloads reconciliation results into management reporting tools and performs the tracking, research and resolution of identified discrepancies.
+ Engages in membership eligibility research, requiring critical thinking skills and the ability to analyze and resolve payment discrepancies, to maximize the collection of accurate revenue.
+ Provides management with monthly established Financial Indicators.
+ Quantifies and documents revenue implications of payment discrepancies.
+ Contributes to the development and documentation of reconciliation workflows and educational tools used to facilitate cross training and internal controls.
+ Performs other duties as assigned. Additional Responsibilities:
**Education/Experience:**
+ High School or GED. A Bachelors degree in a related field may substitute for 2 years experience in any combination of Reconciliation, Auditing, Accounting or Analytics.
+ 2+ years of experience in any combination of Reconciliation, Auditing, Accounting or Analytics.
+ Health insurance experience preferred.
+ Government program regulations experience preferred.
Pay Range: $18.66 - $31.73 per hour
Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. Total compensation may also include additional forms of incentives.
Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act
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